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Topic: Billing for Medicare (Read 3745 times)

I am in the process of starting my own medical billing company. I currently work in a physicians office and when we changed addresses and billing companies it took atleast 3 months for medicare to start paying claims again. I have heard this from other billing agencies as well. I can understand taking a little longer since we changed our address but why does it take so long if you just change billing companies?

That's government efficiency for you! We changed 1 line of our address and it took 9 months!

I wish I had a good explanation for the length of time it takes, but I just kept telling me it's because it's one agency handling any and all changes to all Medicare providers across the nation. That's a lot! Factor in address changes, bank changes (for ERA's), billing company changes, practice changes (individuals to groups and groups to individuals) and it adds up to a lot of changes to process. Also, if a certain amount of time has passed, and you make a change, you have to re-credential. Any errors to the paperwork and it all gets sent back to the provider.

It's inefficient, but think of all the interest they accrue from not paying the providers in the interim! (Sarcasm)

I often wish we billers had the job of processing government paperwork, we could get the country back on its feet and rolling in no time since we are all efficient!!!

If you are just changing billing services it should not take 3 months. The EDI paperwork usually only takes 7-10 days (usually less). Billing can be done as long as the paperwork to notify Medicare of the billing service change is submitted within 30 days. You don't have to wait to bill until the CMS application is finished.

I know that the physician I work for told me that he does not want to change billing companies because it takes medicare atleast 3 months to start paying claims again. Not sure where this info comes from but that would definately make it much harder to recruit new physicians to my billing company. 7-10 days seems more reasonable.

You are supposed to notify Medicare of all changes, including billing services. Most people don't do that, but it is what you are supposed to do. But it doesn't have to be done before billing can begin. The only paperwork that must be done to bill is EDI, and that is not involved. NY only takes about 5-7 days.

The EDI paperwork is to change clearinghouses - here in TN, it took about 4 weeks for Medicare to process. The CMS 855B / I (depending on group or individual) is the form for notifying Medicare that the provider will be utilizing a billing company. I agree with Michele - you can submit claims and get paid while that application is being procesed.